Yeah if you have liver damage/problems, it will be harder to properly metabolize certin drugs I am sure, so you will just end up pissing out half of your drugs and shit, so i imagine you could potentially end up need a higher dose in certain cases. Some people I know metabolize methadone rapidly due to HIV treatments, and they take abnormally high doses of methadone at my clinic, and get split dosing as well. Dunno the specifics off hna.d